Giant omental cyst masquerading as hemorrhagic ascites.

A 5-year-old boy was seen with a history of gradually increasing abdominal distension from the age of 6 mo associated with diarrhea but no history of fever, jaundice, dyspnoea or swelling of extremities. He was undergoing repeated ‘ascitic’ taps from 1.5 yrs age and was on diuretics and anti-tuberculous treatment inspite of negative stains and DNA analysis. While the initial 2 taps were clear (predominant lymphocytes, protein 3.6 g/dL), all later taps were hemorrhagic with no malignant cells. Coagulation profile, renal and liver function tests, serum amylase, echocardiogram, barium meal, duodenal biopsy and Tc99m Sulfur colloid blood pool study were normal. Ultrasonography and computed tomography (CT) scan were reported to be consistent with ascites (Fig. 1). He had been seen by 5 doctors and received 2 blood transfusions during this period.